Key points to remember

• the benefits of immunisation far outweigh the risks
• there is a whooping cough (pertussis) epidemic in New Zealand at the moment, and infants are at greatest risk
• delaying the first immunisation puts infants at risk
• infants are not considered adequately protected until they have had their five month immunisations
• breastfeeding does not offer any significant protection against whooping cough
• whooping cough vaccine is currently funded for pregnant women between 28-38 weeks of pregnancy
• infants can catch whooping cough from older brothers and sisters, parents or even grandparents. If you have a baby or toddler, make sure your older children are up-to-date with their immunisations. Adults can also be vaccinated to protect infants they are in close contact with
• a vaccine (called GARDASIL®) can protect young women and girls against the cause of about 70 percent of cervical cancers
• flu (influenza) immunisation is important, and free, for children with long-term health conditions, who may develop complications from the flu

Why does my child need immunisation?

In the past, diseases such as diphtheria, tetanus and whooping cough killed many children. Today, we use vaccines to immunise children against these and other diseases.

Immunisation (or vaccination) has wiped out some of the killer diseases of childhood in New Zealand. Tetanus is not common any longer (although it still occurs in children who haven't been immunised) and New Zealand is free of polio and diphtheria. While these diseases still exist in other countries, however, they are only a plane ride away.

What is immunisation?

See the Immunisation Advisory Centre (IMAC) website for:

• an immunisation overview
• further information about immunisation
• FAQs (frequently asked questions), such as "Will immunisation be too much for my baby's immune system?" etc

See the Ministry of Health website for:

• information about immunisation in New Zealand
• The Immunisation Handbook 2011 (which provides detailed information for health professionals but may be of interest to those parents who want more comprehensive information)

Funded vaccines against the following diseases are available for children in New Zealand

• diphtheria
• hepatitis B
• Haemophilus influenzae type b (Hib)
• measles
• mumps
• pneumococcal disease
• polio
• rubella
• tetanus
• whooping cough (also known as pertussis)
• human papillomavirus (HPV) (which causes cervical cancer)

These diseases / infections have been chosen for immunising against because they are among the most dangerous to our children and because we have effective vaccines available against them.

For information on these diseases, see:

• vaccine preventable diseases at the Immunisation Advisory Centre (IMAC) website
• call IMAC on 0800 IMMUNE (0800 466863), weekday 9am - 4.30pm

Current and recent epidemics in New Zealand

There have been epidemics of the following two diseases in recent years in New Zealand:

• whooping cough (pertussis) (see the section Whooping cough below)
• meningococcal disease (see the section Meningococcal disease below)

The following disease has also been having a significant impact in our communities:

• pneumococcal disease (see the section Pneumococcal disease below)

Whooping cough (pertussis)

This is a serious disease in children, especially those who haven't been immunised and are less than one year old.

There is a current epidemic of whooping cough in New Zealand since late 2011.

For more information, see the following fact sheets on this website:

• Immunisation: whooping cough
• Whooping cough (information about the disease)

Meningococcal disease

Meningococcal disease is a bacterial infection which causes severe illnesses including meningitis (an infection of membranes that cover the brain) and septicaemia (a serious infection in the blood).

There are several different strains of bacteria which cause meningococcal disease.

• type B is the most common disease causing strain in New Zealand, and there is currently no vaccine available
• type C is the second most common strain, and there are vaccines available for private purchase

The Meningococcal B Immunisation Programme was designed to help control an epidemic of a New Zealand-specific strain of meningococcal B disease. The Immunisation Programme began in 2004 for all under-20-year-olds (those at highest risk) and ended in 2006. Routine immunisation for babies and preschoolers continued until June 2008. The last phase of the programme, immunisation for people with a high medical risk, ended in March 2011.

The number of people developing meningococcal disease due to the epidemic strain of meningococcal B has significantly decreased from over 300 cases in 2001 to fewer than 30 cases in 2010. This meant this vaccination is no longer needed to control an epidemic.

It is important to remember that even though there are now fewer cases, the disease has not disappeared completely.

For more information, see the following:

• Meningococcal disease on this website
• Meningococcal disease in New Zealand at the Ministry of Health website
• Meningococcal disease vaccination at the Ministry of Health website

Pneumococcal disease

The bacteria ‘Streptococcus pneumoniae’ causes infections in different parts of the body such as the sinuses (sinusitis) and in the ear (ear infection or otitis media). When it attacks other parts of the body it becomes ‘invasive’ resulting in very serious infections including pneumonia, septicaemia (blood poisoning) and meningitis (inflammation of the brain lining). Babies and young children with pneumococcal disease can get very sick and some die.

New Zealand has had relatively high rates of pneumococcal disease but disease rates in children under two years of age have halved since a pneumococcal vaccine was first added to New Zealand’s routine vaccinations in 2008.

There are over 90 different types (strains) of pneumococcal bacteria. Before 1 July 2011 the pneumococcal vaccine covered the seven most common pneumococcal types that cause disease in infants and young children.

Since 1 July 2011 children have been getting more protection from pneumococcal disease. Premature babies and children with medical conditions that put them at high risk of becoming seriously ill with pneumococcal disease are being offered a vaccine that provides protection against 13 instead of seven strains.

All other New Zealand children are being offered a pneumococcal vaccine that protects against 10 instead of seven strains.

For more information about pneumococcal disease, see the IMAC (Immunisation Advisory Centre) website.

See the following fact sheets on this website:

• ear infections (detailed and brief versions)
• pneumonia

Cervical cancer

Cervical cancer is cancer of the cervix. (The cervix is the lower part of the uterus or womb, and is at the top of the vagina.)

Cervical cancer is caused by a common virus called human papillomavirus (HPV) that is spread through sexual contact.

About four out of five people have HPV infection at some time in their lives but most HPV infections clear naturally and don't develop into cervical cancer. If abnormal cells occur and go untreated, cervical cancer can result many years later.

The cervical cancer or HPV Immunisation Programme, which began in September 2008, aims to reduce cervical cancer in New Zealand by protecting girls and young women against HPV infection.

The vaccine being used in the New Zealand Programme is GARDASIL^® which protects against the cause of about 70 percent of cervical cancers.

For more information about cervical cancer immunisation, see:

• Immunisation: cervical cancer on this website

Influenza

Influenza, commonly called 'the flu', is an infection caused by the influenza virus. The flu can be a serious and sometimes life-threatening infection. It infects many people every year during the winter months in New Zealand.

Flu immunisation offers the best protection. It strengthens your child's ability to fight the flu.

Flu immunisation is especially important, and free, for children with certain long-term (chronic) health conditions. This is because these children are most likely to develop complications from the flu, such as chest infections.

For more information about influenza, see:

• on this website - Immunisation: The flu
• the influenza pages at the Ministry of Health website
• The National Influenza Specialist Group website

Where to go for immunisation

Vaccines are usually given by the practice nurse at your family doctor’s surgery.

NIR (The National Immunisation Register)

New Zealand’s NIR (National Immunisation Register) records children’s immunisations. This helps keep track of what your child has been given and makes sure that when changing doctors, the records move too.

• the NIR pages at the Ministry of Health website
• questions and answers about the NIR at the Ministry of Health website
• brochures about the NIR for parents in English (at right) and the following languages:
  – Arabic
  – Cook Island Māori
  – Fijian
  – Hindi
  – Korean
  – Māori
  – Niuean
  – Samoan
  – Simplified Chinese
  – Tongan  
  – Tokelauan
  – Traditional Chinese

New Zealand childhood immunisation schedule

The national immunisation schedule is the series of vaccines that are offered free to babies, children and adolescents (and adults). The schedule lists the immunisations and the age at which they’re given. See the schedule (at right) at:

• the Ministry of Health website

• build your own immunisation calendar

Be there for your baby during immunisations - If you are confident, your baby will be too

Parents can help decrease anxiety about immunisations in a number of ways:

• start immunising on time at six weeks of age
• remain calm and relaxed, even when your child becomes upset
• breast feeding reduces the baby's pain
• book your appointment early in the day before everyone is tired
• plan a calm day
• bring along a stuffed toy or blanket for your child to hold during the immunisation, or use them yourself as a tool for distraction
• hold your child firmly during the procedure, talking calmly and gently stroking the child's arm or back
• after being pricked by the needle, your child may cry for a brief time. It is his or her way of coping. Your job is to comfort, hold, and talk supportively
• you will need to remain in the clinic for 20 minutes after the immunisation. Rather than leave immediately, stay in the practice until your child has calmed down. This will help your child to remember the clinic as a nice place and will help to make the next visit easier
• for babies, book your appointment to allow you to feed your child immediately after they have had their immunisation

After immunisation

Around one in ten children can expect a reaction to an immunisation. The vast majority of these are mild, such as redness on the arm or a grizzly child for a day or two. A reaction is an expected sign that the immune response is building and the vaccine is working. Occasionally, more concerning reactions occur like prolonged crying. Although worrying at the time, research shows there are no long-term problems following such reactions. However, if you are concerned, contact your nurse or doctor.

Very rarely, a serious allergic reaction (anaphylaxis) can happen. This is treatable and occurs very shortly after the injection. This is why you must wait at the clinic for 20 minutes after vaccination. If you are concerned, contact your practice nurse or doctor straightaway.

For information about the safety of vaccines, check the websites listed below.

Informed choice

Immunisation is not compulsory in New Zealand but it is a wise parenting choice. There is a lot of information on immunisation and this can be confusing. It's important to check out the source of the material before accepting the conclusions offered. Question critically:

• is it based on sound evidence?
• is it up-to-date information taking the latest research into consideration?
• does it relate to New Zealand?

The IMAC website provides information on a range of diseases, comparing the effects of each disease with the side effects of the relevant vaccine. You'll need to click on "Read more" under each disease to see this information.

Where to go for more information

HealthEd website – Ministry of Health  www.healthed.govt.nz
See the Childhood Immunisation: More information for parents booklet (at right).

Acknowledgements